Peritoneal Dialysis In Critically Ill Patients With Acute Kidney Injury: Time To Revisit?

Acute kidney injury (AKI) frequently complicates admission to the intensive care unit.Dialysis required for AKI has a high mortality rate.The use of peritoneal dialysis (PD) in the management of AKI has declined due to the rapid adoption of extracorporeal continuous renal replacement therapy.This is despite the fact that PD for AKI has potential advantages such as technical simplicity, low cost, and greater hemodynamic stability as compared to hemodialysis or continuous renal replacement therapy (CRRT).There is now evidence to support the use of PD in critically ill patients.In AKI, there was no significant difference between PD and extracorporeal therapy in terms of mortality, recovery of renal function, or infectious complications.Improved techniques for establishing PD access, as well as the availability of automated cyclers and dialysate solutions, have increased efficacy and decreased the number of PD complications.Capacity building of healthcare personnel can increase familiarity and comfort with PD.This modality can be a reasonable and sometimes better option for critically ill patients in both resource-limited and resource-replete situations.